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Febrile transfusion reaction — RCPSC IM MCQ

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HardHematologyFebrile transfusion reactionRCPSC IM

A 63-year-old woman receiving red blood cells for anemia develops fever, rigors, flank pain and hypotension 20 minutes after the transfusion starts. Urine becomes dark. Clerical check reveals the unit may have been intended for another patient. What is the most appropriate next step?

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Correct answer: A — Stop the transfusion, maintain IV access with saline and notify transfusion medicine urgently

Fever, flank pain, hypotension and hemoglobinuria shortly after starting transfusion suggest acute hemolytic transfusion reaction. The transfusion must be stopped immediately and transfusion medicine notified for urgent workup.

Reference: Canadian Blood Services transfusion reaction guidance